Resuscitation apparatus for simultaneous cardiac massage and artificial respiration

ABSTRACT

A light and self-contained device which allows resuscitation of an accident victim by a single person, even if inexperienced in resuscitation techniques. The apparatus has a base on which are mounted two vertical columns which are sufficiently spaced apart to admit the chest of a prone person. On the upper portions of these columns slides a cross-piece which can be clamped on the columns at an adjustable distance from the base. A vertical cylinder is mounted below the centre of the crosspiece and in it slides a piston provided with two piston rods. The upper rod is linked to a second order lever with which the piston can be reciprocated vertically. The lower piston rod is provided at its lower end with a rubber-based plunger for application to the chest of the patient. The upper end of the cylinder is linked by a pipe to a rubber air reservoir balloon. The lower end of the cylinder is linked by a pipe to a bellows made of a flexible, synthetic material. The air reservoir balloon is connected by a pipe to a face-mask for pumping air to the patient. The bellows is linked to a pistol with a manually controlled valve for suction of vomit from the mouth of the patient. In the piping of the face-mask is situated a safety valve set for a determined excessive air pressure, and on the pipe circuit for suction of vomit is placed a vomit reservoir. By means of T-pieces, the pipes connecting the cylinder to the balloon and the bellows are connected to a three-way valve on the crosspiece, allowing the connection to atmosphere of one or the other of these elements. A movable panel between the columns supports the head and chest of the patient and movement of the panel allows the plunger to be situated precisely at the base of the sternum of the patient. The handle of the lever is adjustable and dynamometric, so that the force applied to the chest by the plunger can be adjusted to the size of the rib cage and the age of the patient, to avoid possible fracture of the ribs.

Elite States Derouineau i atent 1 RESUSCITATHON APPARATUS FORSIMULTANEOUS CARIDIAC MASSAGE AND ARTIFICIAL RESPIRATION [76] Inventor:Ren Derouineau, Moulin de Pelissey, Gradignan, France [22] Filed: May26, 1972 [21] App]. No.: 257,076

Primary ExaminerLawrence W. Trapp Att0rneyLorimer P. Brooks et al.

[57] ABSTRACT A light and self-contained device which allows resuscitation of an accident victim by a single person, even if inexperiencedin resuscitation techniques. The apparatus has a base on which aremounted two vertical columns which are sufficiently spaced apart toadmit the chest of a prone person. On the upper portions of thesecolumns slides a cross-piece which can be clamped on the columns at anadjustable distance from the base. A vertical cylinder is mounted belowthe centre of the crosspiece and in it slides a piston provided with twopiston rods. The upper rod is linked to a second order lever with whichthe piston can be reciprocated vertically. The lower piston rod isprovided at its lower end with a rubber-based plunger for application tothe chest of the patient. The upper end of the cylinder is linked by apipe to a rubber air reservoir balloon. The lower end of the cylinder islinked by a pipe to a bellows made of a flexible, synthetic material.The air reservoir balloon is connected by a pipe to a face-mask forpumping air to the patient. The bellows is linked to a pistol with amanually controlled valve for suction of vomit from the mouth of thepatient. In the piping of the face-mask is situated a safety valve setfor a determined excessive air pressure, and on the pipe circuit forsuction of vomit is placed a vomit reservoir. By means of T-pieces, thepipes connecting the cylinder to the balloon and the bellows areconnected to a three-way valve on the crosspiece, allowing theconnection to atmosphere of one or the other of these elements. Amovable panel between the columns supports the head and chest of thepatient and movement of the panel allows the plunger to be situatedprecisely at the base of the sternum of the patient. The handle of thelever is adjustable and dynamometric, so that the force applied to thechest by the plunger can be adjusted to the size of the rib cage and theage of the patient, to avoid possible fracture of the ribs.

10 Claims, 3 Drawing Figures RESUSCITATION APPARATUS FOR SIMULTANEOUSCARDIAC MASSAGE AND ARTIFICIAL RESPIRATION The present inventionconcerns an emergency resuscitation device, providing for simultaneouscardiac massage and artificial respiration at the site of the emergency.

After an accident, drowning, suffocation, electrocution or heart attack,current techniques call for cardiac massage or artificial respiration bythe mouth-to-mouth (kiss of life) method or by pneumatic pumping; thetwo processes are carried out successively or simultaneously, andnecessarily for short periods. Two qualified persons are required forthe application of these methods, and to obtain a real efficiency theirefforts must be synchronized and conjugated. The cardiac massage is ofcourse an external one effected by pressing of the chest wallvigourously and at a rate of 60 to 70 times per minute, so as tocompress the heart. These operations can last for half an hour or more,observing as closely as possible the correct rhythm. This emergencytreatment is thus difficult and exhausting, requiring prolonged effortand occasionally involving blows which are to be avoided in the case ofcardiac massage, which must be gentle.

If the patient has suffered the initial stages of asphyxiation by gas orliquid, respiratory movements and pumping of air into the lungs must besimultaneously provided, at a given rateand for a given period of time.When resuscitation must be carried out urgently, the mouth-to-mouthmethod is indicated, but it is difficult and unpleasant, both as regardsthe time required and the synchronisation with the massage of the heartand the effort required to overcome the repugnance of contact with amouth which may be filled with vomit.

Various devices are known, based on the principle of a plunger movedmechanically or pneumatically for carrying out the massage. Some use apressurised liquid acting on the plunger and serving for the directionof air into the lungs. These devices are mechanically complicated,however, and comprise a bulky power source. They do not provide forsynchronisation of the resuscitation processes.

To reduce these disadvantages, the present invention provides a verylight and self-contained device which allows the resuscitation processesto be safely combined by a single person, even if inexperienced. A leverlinked to a double-acting piston and cylinder arrangement allows cardiacmassage, pumping of air into the lungs, and suction of vomit to becarried out separately or simultaneously.

The apparatus is formed by a base plate on which are mounted twovertical columns, which may be mounted in a hinged manner, and which aresufficiently spaced apart to admit the chest of a prone person.

On the upper portions of these columns slides a cross-piece which may beso mounted that it can be moved out of the way to admit the body of apatient, and which can be clamped on the columns at an adjustabledistance from the base plate.

A vertical cylinder is mounted below the centre of the crosspiece and init slides a piston provided with two piston rods. The upper rod slidesvertically and in fluid-tight manner in the upper closure of thecylinder and is linked to a second order lever pivoted to the top of thecrosspiece at one end and having a handle at the other end. With thishandle the lever and the piston can be reciprocated vertically.

The lower piston rod slides vertically and in fluidtight manner in thelower closure of the cylinder and is provided at its lower end with arubber-based plunger for application to the chest of the patient.

The upper end of the cylinder is provided with an air inlet valve and anozzle linked by a pipe to a rubber air reservoir balloon, the assemblythus constituting an air pump.

The lower end of the cylinder is provided with an air outlet valve and anozzle linked by a pipe to a bellows made of a flexible syntheticmaterial, the assembly forming a vacuum pump.

The air reservoir balloon is connected by a pipe to a valve on thehandle of the lever while the bellows is connected by another pipe to avomit suction valve.

By means of T-pieces', the pipes connecting the cylinder to the balloonand the bellows are connected to a three-way valve on the crosspiece,allowing the connection to atmosphere of one or other of these elements,so putting the corresponding pump out of service. I

The valve on the lever has an outlet for receiving a tube connected to aface-mask, by means of a quick release joint, for pumping air to thepatient.

The outlet of the bellows is linked by a quick release joint to a pipeattached to a pistol with a manually controlled valve for suction ofvomit, by means of the bellows, the pistol being placed in the mouth ofthe patient.

In the piping of the face-mask is situated a safety valve set for adetermined excessive air pressure, and on the pipe circuit for suctionof vomit is placed a vomit reservoir.

A movable panel of synthetic material is placed between the columns. Thehead and chest of the patient being fixed to this panel, movement of thepanel allows the plunger to be situated precisely at the base of thesternum of the patient.

The handle of the lever is adjustable and dynamometic, so that the forceapplied to the chest by the plunger can be adjusted to the size of therib cage and the age of the patient, to avoid possible fracture of theribs.

A characteristic of the present invention is to provide resuscitationapparatus for first aid to victims of heart attacks, suffocation,accident s, drowning, electrocution and the like. The apparatus islight, self-contained, of certain efficiency, and can be used by asingle person even if inexperienced in the practice of cardiac massageand artificial respiration.

Another characteristic of the invention is to provide the apparatus witha base plate supporting two vertical columns which can be stowed in ahorizontal position and which carry at their upper end portions acrosspiece which can be adjusted relative to the base plate and clamped:the space between these elements receives the chest of a patient,supported on a movable panel.

Another characteristic of the present invention is to mount below thecentre of the crosspiece a vertical cylinder in which slides a pistonattached to two piston rods, the upper rod sliding in fluid-tight mannerin the upper closure of the cylinder and the lower rod sliding influid-tight manner in the lower closure of the cylinder. The free end ofthe lower rod is provided with a rubber plunger for external cardiacmassage.

Another characteristic of the invention is to link the free end of theupper rod to a second-order lever supported on the crosspiece, its freeend being provided with a handle for reciprocating the piston verticallywithin the cylinder.

Another characteristic of the present invention is to provide the upperend of the cylinder with an air inlet valve and a nozzle linked by apipe to a rubber vessel forming a compressed air reservoir, and toprovide the lower end of the cylinder with an air outlet valve and anozzle linked by a pipe to a bellows of a flexible synthetic materialforming a vacuum reservoir.

Another characteristic of the invention is to connect the inlet pipes ofthe compressed air and vacuum reservoirs to a three-way valve mounted onthe crosspiece and with which either of these elements may be put out ofservice by connecting it to atmosphere.

Another characteristic of the present invention is to provide at theoutlet of the compressed air reservoir a pipe connected to a manuallycontrolled valve on the handle of the lever for controlling pumping ofair to the patient by means of a face-mask coupled to the valve by meansof a pipe and a quick release fastening.

A characteristic of the present invention is to provide in the airpumping circuit, between the control valve and the face-mask, a safetyvalve set for an excessive pressure.

Another characteristic of the invention is to provide on the vomitsuction path, between the quick release fastening and the pistol, avomit reservoir.

Another characteristic of the invention is to provide the lever with anadjustable, dynamometric handle for limiting the pressure of the rubberplunger on the chest of the patient, according to the age and physicalcondition of the patient, so as to avoid if possible excessivecompression of the sternum and rib cage which can, especially ifprolonged, cause fracture of the ribs.

The apparatus is arranged to carry out rapidly and readily allresuscitation operations, that is to say external cardiac massage, orpumping of air into the lungs, or clearing the thoracic passages byremoval of vomit which might impede the attempt to reestablishrespiration.

Other characteristics of the invention will emerge from the followingdescription with reference to the accompanying drawing which showsschematically and by way of example selt contained resuscitationapparatus.

In the drawing FIG. 1 is a front elevation of the apparatus,

FIG. 2 is a plan view corresponding to FIG. 1,

FIG. 3 is a side view corresponding to FIG. 1.

The base plate 1 of the apparatus supports columns 2 and 3 which receiveon their upper portions a crosspiece 4 which can be adjusted in heightand clamped by means of knurled knobs 5 and 6. A cylinder 7 in whichslides a piston 8 provided with piston rods 9 and 10 is mounted on theapparatus. The lower rod 9 slides in fluid-tight manner in the lowerclosure 11 of the cylinder and the upper rod 10 slides in fluid-tightmanner in the upper closure 12. The lower rod 9 carries a rubber plunger13 at its free end. The upper rod 10 is coupled to a lever 14 of whichone end is fixed to the cross piece 4 by means of a link 15 and theother end is provided with a dynamometric handle 16 adjustable by meansof a knurled knob 17. The upper end 12 of the cylinder is provided withan inlet valve 18 and is connected by a pipe 19 to a rubber balloon 20forming a compressed air reservoir. The lower end 11 is provided,

with an outlet valve 21 and is linked by a pipe 22 to the vacuumreservoir 23. Pipes l9 and 22 are connected to a three-way valve 24mounted on the crosspiece 4.

The outlet pipe 25 from the compressed air reservoir 20 is connected toan air pumping valve 26 through a pipe 27 provided with a safety valve28 and a quickrelease fastening 29. The fastening 29 receives a pipe 30leading to a face-mask (not shown).

The outlet pipe 31 from the vacuum reservoir 23 terminates in aquick-release fastening for receiving one end of a vomit suction pipeincorporating a vomit reservoir 33 and whose free end is attached to apistol-valve 34 for suction of vomit. I

A mobile panel 35 is mounted so as to slide on the base plate 1 and hasa support 36 for the head of a patient, secured to the support 36 bymeans of a strap attached to hooks 37 and 38.

The columns 2 and 3 carry respective sliding supports 39 and 40 on whichare clamped buffers 41 and 42 for locating the chest of the patient 43.

If the patient 43 needs combined cardiac massage and air, the patient isdisposed on the panel 35 between the columns 2 and 3, with his headsecured to the support 36 and so that the plunger 13 is above the baseof the sternum. The buffers 41 and 42 are pressed against the sides ofthe rib cage and the three-way valve 24 is positioned so that bothreservoirs 20 and 23 are in service. The face-mask is applied to themouth of the patient and the lever is manoeuvered to give foursuccessive massages at a rate of approximately 60 to per minute. Thevalve 26 is then opened for three seconds after which the manoeuvre isresumed at the same rhythm. The rubber balloon 20 is filled withcompressed air by the co-operation of piston 8 and air inlet valve 18.Raising of the piston and the lever can be assisted by a spring (notshown). At the same time a partial vacuum is created in the reservoir 23by the cooperation of the piston 8 and the air outlet valve 21.

If the mouth or adjacent internal organs of the patient are obstructedby vomit, the face-mask is lifted and the vomit is sucked into thereservoir 33 by means of the pistol 34.

If the patient does not require a supply of air the three-position valve24 is set so that the vessel 20 is connected to atmosphere. The pistol34 can be used, the vacuum reservoir 23 being still in service.

All operative combinations of the apparatus can be selected by means ofthe three-way valve 24.

It will be appreciated that the invention has been described by way ofnon-limitative example only, and that various details are subject tomodifications lying within the spirit and scope of the invention. Thusthe columns 2 and 3 might be articulated at their lower ends so that thepatient could be placed directly in the best position on the mobilepanel '35. Alternatively, the columns could be fixed and the crosspiece4 could have one end detachable from the column so that it could beswung out of the way to allow the patient to be placed on the panel 35,the panel being movable by means of a suitable known screw or jackdevice.

I claim:

1. Resuscitation apparatus comprising:

a generally horizontal support for a patient;

at least one vertical upright on said support;

a crosspiece mounted on said upright for vertical displacements relativethereto;

means for locking said crosspiece on said upright at a predetermineddistance from said support;

an air cylinder mounted on said crosspiece for vertical displacementtherewith;

a piston mounted for vertical sliding motion in fluidtight manner withinsaid cylinder;

a manually operable actuator mounted on said crosspiece and connected tosaid piston for reciprocating said piston within said cylinder andthereby alternately displacing air between the upper end of saidcylinder and said piston and between the lower end of said cylinder andsaid piston;

a piston rod attached to said piston and extending downwardly from saidpiston and out of the lower end of said cylinder;

means in said cylinder defining a fluid-tight passage for said pistonrod through said lower end of said cylinder;

a resilient plunger at the end of said piston rod remote from saidpiston, for application to the chest of said patient to effect externalcardiac massage;

means defining first inlet and exhaust ports in said cylinder on oneside of said piston and means defining second inlet and exhaust ports insaid cylinder on the opposite side of said piston;

a compressed air reservoir connected to said exhaust port at said oneside of said piston;

a vacuum reservoir connected to said inlet port at said opposite side ofsaid piston;

a suction device connected by a pipe to said vacuum reservoir; and

valve means connected to said compressed air and vacuum reservoirs andoperable to place either of said reservoirs separately in communicationwith the atmosphere.

2. Apparatus as set forth in claim 1, wherein said actuator comprises alever pivoted at one end to said crosspiece and articulated intermediateits ends to said piston, and further comprising an adjustabledynamometric handle at the opposite end of said lever for limiting theforce applicable to said lever by force applied to said handle, wherebythe force exerted on the patient during cardiac massage can beregulated.

3. Apparatus as set forth in claim 1, wherein said compressed airreservoir comprises a vessel of an elastic material and said vacuumreservoir comprises a resilient bellows, and further comprising a vomitreceptacle connected to said pipe between said vacuum reservoir and saidsuction device.

4. Resuscitation apparatus as set forth in claim 1, wherein said valvemeans comprise a three-way valve operable, in one position thereof, toopen one of said reservoirs to the atmosphere, in a second positionthereof, to open the other of said reservoirs to the atmosphere and, ina third position thereof to prevent communication of said reservoirswith the atmosphere.

5. Resuscitation apparatus as set forth in claim 1, comprising aface-mask, a flexible pipe connecting said face-mask to said compressedair reservoir, and a safety valve disposed on said flexible pipe betweensaid reservoir and said mask for limiting the pressure of the airsupplied to said face-mask.

6. Resuscitation apparatus as set forth in claim 1, wherein said suctiondevice comprises a suction pistol having a manually operable controlvalve.

7. Resuscitation apparatus as set forth in claim 1, comprising a returnspring disposed and acting between said cylinder and said lever toreturn said lever to a predetermined position.

8. Resuscitation apparatus as set forth in claim 1, comprising a returnspring inside said cylinder and disposed and acting between said pistonand said cylinder to return said piston to a predetermined position.

9. Resuscitation apparatus as set forth in claim 1, comprising twovertical uprights pivotally mounted on said patient support to permitfolding thereof to respective horizontal positions, said crosspiecespanning the space between said uprights.

l0. Resuscitation apparatus comprising:

a generally horizontal support for a patient;

at least one vertical upright mounted on said support;

a crosspiece mounted on said upright for vertical displacements relativethereto;

means for locking said crosspiece on said upright at a predetermineddistance from said support;

a cylinder mounted on said crosspiece for vertical displacementtherewith;

a piston mounted for vertical sliding motion in fluidtight manner withinsaid cylinder;

a piston rod attached to said piston and extending downwardly from saidpiston and out of the lower end of said cylinder;

means in said cylinder defining a fluid-tight passage for said pistonrod through said lower end of said cylinder;

a resilient plunger at the end of said piston rod re mote from saidpiston, for application to the chest of said patient to effect externalcardiac massage;

means defining first inlet and exhaust ports in said cylinder on oneside of said piston and means defining second inlet and exhaust ports insaid cylinder on the opposite side of said piston;

a compressed air reservoir connected to said exhaust port at said oneside of said piston;

a vacuum reservoir connected to said inlet port at said opposite side ofsaid piston;

a suction device connected by a pipe to said vacuum reservoir;

valve means connected to said compressed air and vacuum reservoirs andoperable to place either of said reservoirs separately in communicationwith the atmosphere; and

a manually operable actuator mounted on said crosspiece and connected tosaid piston to produce displacement of said piston with respect to saidcylinder and thereby causing during displacement of said piston in afirst direction a cardiac massage movement of said plunger and areduction of the air volume on one side of said piston and during thereturn stroke of said piston in a direction opposite to said firstdirection a vacuum on said one side of said piston and a compression ofair at said other side of said piston.

1. Resuscitation apparatus comprising: a generally horizontal supportfor a patient; at least one vertical upright on said support; acrosspiece moUnted on said upright for vertical displacements relativethereto; means for locking said crosspiece on said upright at apredetermined distance from said support; an air cylinder mounted onsaid crosspiece for vertical displacement therewith; a piston mountedfor vertical sliding motion in fluid-tight manner within said cylinder;a manually operable actuator mounted on said crosspiece and connected tosaid piston for reciprocating said piston within said cylinder andthereby alternately displacing air between the upper end of saidcylinder and said piston and between the lower end of said cylinder andsaid piston; a piston rod attached to said piston and extendingdownwardly from said piston and out of the lower end of said cylinder;means in said cylinder defining a fluid-tight passage for said pistonrod through said lower end of said cylinder; a resilient plunger at theend of said piston rod remote from said piston, for application to thechest of said patient to effect external cardiac massage; means definingfirst inlet and exhaust ports in said cylinder on one side of saidpiston and means defining second inlet and exhaust ports in saidcylinder on the opposite side of said piston; a compressed air reservoirconnected to said exhaust port at said one side of said piston; a vacuumreservoir connected to said inlet port at said opposite side of saidpiston; a suction device connected by a pipe to said vacuum reservoir;and valve means connected to said compressed air and vacuum reservoirsand operable to place either of said reservoirs separately incommunication with the atmosphere.
 2. Apparatus as set forth in claim 1,wherein said actuator comprises a lever pivoted at one end to saidcrosspiece and articulated intermediate its ends to said piston, andfurther comprising an adjustable dynamometric handle at the opposite endof said lever for limiting the force applicable to said lever by forceapplied to said handle, whereby the force exerted on the patient duringcardiac massage can be regulated.
 3. Apparatus as set forth in claim 1,wherein said compressed air reservoir comprises a vessel of an elasticmaterial and said vacuum reservoir comprises a resilient bellows, andfurther comprising a vomit receptacle connected to said pipe betweensaid vacuum reservoir and said suction device.
 4. Resuscitationapparatus as set forth in claim 1, wherein said valve means comprise athree-way valve operable, in one position thereof, to open one of saidreservoirs to the atmosphere, in a second position thereof, to open theother of said reservoirs to the atmosphere and, in a third positionthereof to prevent communication of said reservoirs with the atmosphere.5. Resuscitation apparatus as set forth in claim 1, comprising aface-mask, a flexible pipe connecting said face-mask to said compressedair reservoir, and a safety valve disposed on said flexible pipe betweensaid reservoir and said mask for limiting the pressure of the airsupplied to said face-mask.
 6. Resuscitation apparatus as set forth inclaim 1, wherein said suction device comprises a suction pistol having amanually operable control valve.
 7. Resuscitation apparatus as set forthin claim 1, comprising a return spring disposed and acting between saidcylinder and said lever to return said lever to a predeterminedposition.
 8. Resuscitation apparatus as set forth in claim 1, comprisinga return spring inside said cylinder and disposed and acting betweensaid piston and said cylinder to return said piston to a predeterminedposition.
 9. Resuscitation apparatus as set forth in claim 1, comprisingtwo vertical uprights pivotally mounted on said patient support topermit folding thereof to respective horizontal positions, saidcrosspiece spanning the space between said uprights.
 10. Resuscitationapparatus comprising: a generally horizontal support for a patient; atleast one vertical upright mounted on said support; A crosspiece mountedon said upright for vertical displacements relative thereto; means forlocking said crosspiece on said upright at a predetermined distance fromsaid support; a cylinder mounted on said crosspiece for verticaldisplacement therewith; a piston mounted for vertical sliding motion influid-tight manner within said cylinder; a piston rod attached to saidpiston and extending downwardly from said piston and out of the lowerend of said cylinder; means in said cylinder defining a fluid-tightpassage for said piston rod through said lower end of said cylinder; aresilient plunger at the end of said piston rod remote from said piston,for application to the chest of said patient to effect external cardiacmassage; means defining first inlet and exhaust ports in said cylinderon one side of said piston and means defining second inlet and exhaustports in said cylinder on the opposite side of said piston; a compressedair reservoir connected to said exhaust port at said one side of saidpiston; a vacuum reservoir connected to said inlet port at said oppositeside of said piston; a suction device connected by a pipe to said vacuumreservoir; valve means connected to said compressed air and vacuumreservoirs and operable to place either of said reservoirs separately incommunication with the atmosphere; and a manually operable actuatormounted on said crosspiece and connected to said piston to producedisplacement of said piston with respect to said cylinder and therebycausing during displacement of said piston in a first direction acardiac massage movement of said plunger and a reduction of the airvolume on one side of said piston and during the return stroke of saidpiston in a direction opposite to said first direction a vacuum on saidone side of said piston and a compression of air at said other side ofsaid piston.